More than half of Medicare beneficiaries with a serious illness have struggled to afford a medical bill, and some beneficiaries with chronic conditions pay an astronomical amount out of pocket for their care, two new studies find.
Why it matters: Medicare is supposed to be a safety net for America's seniors, but its lack of a cap on what beneficiaries pay out-of-pocket — and the fact that it doesn't cover some benefits — leads to many seniors falling through the cracks.
Driving the news: A new survey published yesterday in Health Affairs found that 53% of seriously ill Medicare beneficiaries said they'd experienced financial hardships while trying to get care.
- Respondents reported having problems paying prescription drug bills most often, followed by hospital bills.
A second brief published by the Kaiser Family Foundation broke down Medicare beneficiaries' out-of-pocket spending, which averaged $5,460 in in 2016, including their premiums.
- The most expensive service for seniors, by far, was long-term care, which isn't covered by Medicare.
- Beneficiaries with diseases likely to require long-term care — like Alzheimer's, other kinds of dementia, or Parkinson’s — had the highest spending.
- Older beneficiaries, women and those in poor health faced higher-than-average costs.
The bottom line: Democrats across the ideological spectrum are leaning into expanding Medicare, but the existing program has plenty of holes.
Go deeper: The looming crisis in long-term care
